MORE SUPPORT FOR CHILDHOOD PREVENTIVE HEALTHCARE AND FERTILITY TREATMENTS

1   In his National Day Rally speech on 18 August 2019, Prime Minister Lee Hsien Loong announced the Government’s plan to provide more support in marriage and parenthood (M&P) for Singaporeans. In line with this, the Ministry of Health (MOH) will:

a) Improve the accessibility and affordability of nationally recommended vaccinations and developmental screenings for children; and
b) Enhance support for couples to meet parenthood aspirations.

Collectively, these will provide better support for Singaporean families.

More Accessible and Affordable Childhood Vaccinations and Developmental Screenings

2   The National Childhood Immunisation Schedule (NCIS) lists childhood vaccinations recommended for protection against common vaccine-preventable diseases in Singapore. Today, MediSave can be used for all NCIS vaccinations. Vaccinations for diseases with high outbreak potential are subsidised at polyclinics, and we have achieved high population coverage for these vaccinations^[1]. However, vaccinations which are recommended for personal protection, such as vaccinations against pneumococcal disease, are currently not subsidised. Take up rates for these vaccines are also much lower, although they offer significant protection against disease.

3   Developmental screenings help with early detection and timely intervention for developmental delays in children. Such screenings are currently subsidised for Singaporean children only at polyclinics.

4   To make recommended screenings and immunisations for children more affordable and convenient for Singaporean parents, MOH will extend subsidies for all vaccinations under the NCIS as well as childhood developmental screenings. These subsidies will be made available at all Community Health Assist Scheme (CHAS) General Practitioner clinics and polyclinics before end 2020. Please refer to the ANNEX for more information on the NCIS vaccinations.

Enhancing Support for Couples to Meet Parenthood Aspirations

5   We continue to encourage couples to marry and start their families early. While many aspire to have children, the probability of pregnancy complications increases with maternal age, and the success rate for assisted reproduction technology (ART) carried out beyond age 40 remains low.

6   At the same time, the safety of ART procedures has improved over the years with medical technology advancements. This has significantly reduced the medical risks for women undergoing ART procedures, even beyond age 45. As such, from 1 January 2020, MOH will lift the age limit of 45 years old for women to undergo ART treatments and remove the cap on the number of ART cycles for all women.

7   Today, government co-funding for up to six ART cycles^[2] is only available for women below 40 years of age at the start of the ART cycle. Eligible couples seeking ART treatment at public assisted reproduction (AR) centres can receive co-funding of up to $7,700 per fresh cycle and $2,200 per frozen cycle, for three fresh cycles and three frozen cycles.

Table 1 – ART Co-Funding Amount per Treatment Cycle

8   From 1 January 2020, the government will enhance the ART co-funding scheme. Up to two of the six co-funded ART cycles can be carried out at age 40 or later, as long as the couple had attempted AR or Intra-Uterine Insemination (IUI) procedures before age 40. They should be medically assessed by their doctor to be fit to carry a pregnancy to term.

9   In addition, government co-funding will be introduced for the less invasive IUI procedure to better support fertility treatment prior to ART treatment. From 1 January 2020, eligible couples undergoing the IUI procedures at the public AR centres will be able to receive co-funding of up to 75%, capped at $1,000 per treatment cycle, for three cycles of IUI.

Table 2 – IUI Co-Funding Amount per Treatment Cycle

10   Couples will need to meet the following criteria to be eligible to receive the co-funding for IUI:

(i) The female spouse should be below 40 years of age at the start of the cycle;
(ii) The couple has been assessed by a doctor at the public AR centre to be suitable to try IUI prior to ART treatment; and
(iii) One spouse must be a Singapore Citizen.

11   These enhancements seek to better support Singaporean families in their marriage and parenthood journeys, and in achieving better health for all.

MINISTRY OF HEALTH
28 AUGUST 2019

[1] For example, coverage is 95% or higher for measles and diphtheria vaccinations
[2] Three fresh ART cycles and three frozen ART cycles

Annex - Current Vaccinations in the National Childhood Immunisation Schedule